{
"Npi": {
"NPI": "1740629914",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CARTER",
"FirstName": "NATALIE",
"MiddleName": "ANNE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DPT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GEISZ",
"OtherFirstName": "NATALIE",
"OtherMiddleName": "ANNE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "DPT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "600 OAKMONT LN",
"SecondLineMailingAddress": "STE 600C",
"MailingAddressCityName": "WESTMONT",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60559-5548",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-575-1980",
"MailingAddressFaxNumber": "630-928-5080",
"FirstLinePracticeLocationAddress": "1047 CENTURY DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EDWARDSVILLE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "62025-3772",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "618-307-3434",
"PracticeLocationAddressFaxNumber": "618-307-3435",
"EnumerationDate": "06/20/2013",
"LastUpdateDate": "06/25/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "2013021014",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "8598488-2401",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "070.021263",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}